Paul Wilson, D.M.D

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

License

D-0007020-C Issued in AL

Practice address

4032 Balmoral Dr SW
Huntsville, AL 35801-6402

Phone

(720) 936-9168

NPI assigned

Jan 31, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southern Comfort Dental Anesthesia

  • Dental Anesthesiology
  • Huntsville, AL
  • NPI 1609599349
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1710345160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 MEADOWGLADE LN",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357586851",
            "telephone_number": "720-936-9168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4032 BALMORAL DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016402",
            "telephone_number": "720-936-9168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-31",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "AL",
            "license": "D-0007020-C",
            "primary": true
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "CO",
            "license": "00203968",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael W Wilson, PH.D
• Mindy Smith Wilson, P.A.-C.
• Miranda Noelle Wilson
• Patricia J Wilson, MD
• Patrick C Wilson, M.D.
• Peter S Wilson, MD
• Sarah Wilson
• Savannah Lynn Wilson, RD, LD
• Stacie Peek Wilson, MS CCC-SLP
• Sydney Wilson

• Dental Anesthesiology in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Dental Anesthesiology in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.